WHAT SHOULD WE STOP DOING WHEN IT COMES TO STUDENT MENTAL HEALTH ISSUES?

Colleges and universities have all been preparing for that “perfect storm” on campuses by creating more and more ways to monitor students of concern. But have institutions gone too far? Have colleges and universities begun to go beyond the scope of services their staffs can provide? And are new liabilities being created for universities as a result?

The Perfect Storm

Prior to the 2007 shooting spree at Virginia Tech, Baylor University had been training faculty, staff, and students regarding student mental health issues. Counseling services, judicial affairs, student life, and the office of general counsel presented several campus-wide mental health summits and provided training for various academic departments. Then post-Virginia Tech, institutions of higher education, including Baylor, began to see an increase in significant student mental health issues occurring on campuses. As student mental health cases at Baylor were reaching peak numbers in 2010, the counseling center staff acknowledged a need to clearly define the scope of service that could be offered at the University. Many of the serious cases they were encountering were students who needed weekly, long-term, specific treatment that the institution was not staffed to provide.

Clearly Defined Scope of Service

While it is not uncommon to think of “scope of service” related to health services, perhaps institutions must begin to think about scope of service issues for other areas of the campus as students of concern cases increase exponentially.

At Baylor, the residence life staff has been trained in responding to threats or harm to self or others; however, as faculty and staff have become more aware of the University’s students of concern reporting process, more and more situations have required asking residence hall staff (both professional and student staff) to check on students of concern who are living in a residence hall. Many of these “student checks” were a result of students missing classes and/or submitting class papers or sending e-mails that contained concerning, but not necessarily alarming, content. Each report seemed to necessitate a “check” on the student thereby taxing housing staff.

As the number of these student checks began to increase, the question regarding scope of service for the residence life staff began to surface. Was the university possibly creating an expectation that the staff would continue the service of repeatedly finding and checking on a particular resident who had been identified as a student of concern? Would this then generate a “duty of care” that the university did not want to create? Was this practice also placing an unrealistic burden on the student staff to carry the weight of correctly identifying warning signs that a student might be moving toward a crisis? As a result, Baylor student life administrators determined that the scope of service for the residence life staff needed to be examined. The student life staff, in consultation with the office of general counsel, worked together to determine what this might look like. Now when residence life staff completes a student check, the staff has a resource sheet they can hand the student. The purpose of this handout is to remove any expectation that it is their duty to continually check back on the student. The handout was also meant to inform the student that it is his or her responsibility to seek out available resources, and the University is not responsible for monitoring whether or not the student has made use of these or other available resources.

The Nation Taking Notice

The explosion of student mental health issues in recent years is gaining national attention beyond the circles of college and university counseling center staffs, faculty, and administrators. In a December 2010 New York Times article titled, “Mental Health Needs Seen Growing at Colleges,” the Times reported “A recent survey by the American College Counseling Association found that a majority of students seek help for normal post-adolescent trouble like romantic heartbreak and identity crises. But 44 percent in counseling have severe psychological disorders, up from 16 percent in 2000, and 24 percent are on psychiatric medication, up from 17 percent a decade ago.”

The 2011 shooting in Tucson, Arizona also brought national attention to student mental health as many turned to Pima Community College for answers regarding Jared Lee Loughner’s past conduct as a student. While Loughner was no longer a student at Pima, it seemed that more news agencies turned to the college for answers regarding Loughner rather than to his parents. This gives a whole new meaning to In Loco Parentis for colleges and universities.

Remembering Our Prime Directive

With the recent national attention on college student mental health, it may seem counterintuitive to be asking, “What should we stop doing?” but institutions must be realistic about what services really go beyond the scope of service their staffs are qualified to provide. For example, the counseling staff at Baylor determined that they needed to refer students to resources in the community or elsewhere when weekly, long-term counseling was needed. Additionally, students and parents need to have a realistic understanding of the limitations that exist on college campuses when it comes to student mental health.

While all institutions of higher education want to see their students be successful, parents, more so than students, need to be reminded that colleges and universities are institutions of higher education and not treatment centers. Sometimes parents seem to view universities as their last hope for a place where their student can “get better.”

Reframing the Conversation

At Baylor’s new student orientation, the chief student conduct officer tries to help parents and students understand that sometimes a university environment is not always conducive to students getting better if they are dealing with significant addictions or mental health issues.

As colleges and universities continue to deal with the increased strain on staff and services as a result of student mental health issues, institutions may need to draw some new lines in the sand. The scope of what services can realistically be offered may need to be carefully reviewed and clarified. If institutions are finding that the mental health issues on their campus are so significant that the needs of the few are beginning to usurp services from the needs of the many, then the hard question, “What do we stop doing?” must become part of the conversation.

Well stated Betty! It’s important to take time to push the pause button sometimes and reflect/ redefine and make constructive changes in orientation for services. Counseling Centers provide a rich resource to the academy but cannot be expected to provide services for all the issues being presented by today’s college students.